Study spotlights personal, health system impact of long COVID (By: Stephanie Soucheray, MA)

A new 12-study meta-analysis outlining the impact of post–COVID-19 condition (PCC), or long COVID, shows substantial functional, daily activity limitation to patients as well as high use of multiple healthcare services. The study is published in JAMA Health Forum.

A second new study highlights the most common long-COVID symptoms in kids.

With more than 750 million confirmed COVID-19 infections globally since March 2020, millions of people around the world now suffer from PCC, defined by the World Health Organization as symptoms occurring at least 3 months after probable or confirmed SARS-CoV-2 infection that last for at least 2 months and cannot be explained by an alternate diagnosis.

More than 100 symptoms have been associated with PCC, and countries such as the United States, Canada, and the United Kingdom have estimated its prevalence.

Surveys: 3% to 7% of population affected

The US Household Use Survey showed an incidence of 13.5% among adults with a history of SARS-COV-2 infection (a prevalence of 6.8% of all US adults), according to the meta-analysis.

The Canadian COVID-19 Antibody and Health Survey reported an incidence of 14.8% among Canadian adults with a history of infection (a prevalence of 4.6% of all Canadian adults), and the UK Office for National Statistics (ONS) reported a prevalence of 3.4% of the entire UK population.

The authors of the study used the aforementioned survey results, and other studies, to evaluate the effects of PCC through a health policy lens.

It is critical that governments understand the magnitude of this burden and plan accordingly.

“The findings of this article suggest that PCC may substantially affect individuals and health systems, and it is critical that governments understand the magnitude of this burden and plan accordingly,” the authors said.

Daily activities affected for most

The three large national surveys from the United States, Canada, and Britain show that a significant proportion of PCC patients have limitations on activities of daily living.

In Canada, 21.3% of those with PCC said they often or always experienced limitations in daily activities. The UK ONS showed 17.3% of respondents said PCC decreases daily living a lot, and 58.6% said their daily activity performance had decreased at least somewhat.

And 78.5% of US adults with PCC experienced some degree of activity limitations, with 23.1% experiencing substantial activity limitations.

Eight studies demonstrated a prolonged increase in the risk of mortality and rehospitalization.

Studies looking at healthcare use, including primary care and specialist visits, spotlighted the healthcare burden of PCC. Rates of primary care use were higher among those in the community (adjusted incidence rate ratio [aIRR], 1.18; 95% confidence interval [CI], 1.17 to 1.19) and those who were hospitalized with COVID-19 (aIRR, 1.73; 95% CI, 1.68 to 1.77) compared with 1 year before SARS-CoV-2 infection.

“Eight studies demonstrated a prolonged increase in the risk of mortality and rehospitalization among those previously hospitalized with COVID-19 compared with controls,” the authors said.

10 common symptoms noted in kids

Finally today, a new study of 205 patients in Vietnam describes 10 common symptoms seen in children with PCC, but only pulmonary rales, fever, and chills showed a significant difference between patients with long COVID and those with hospitalized with a non-COVID respiratory illness. The study is published in The Pediatric Infectious Disease Journal.

Long COVID is not well understood in the pediatric population, the authors of the study write, and studies have described varying estimates of prevalence, from 2% to 58% at least 2 months after infection.

The study occurred during the Omicron variant surge in Ho Chi Minh City from April to August 2022, and all inpatients were ages 1 month to 16 years. The symptoms from a total of 150 children who had been infected with COVID and 55 who did not have COVID were compared.

While diarrhea was rare, pulmonary rales, fever and chills were significantly associated with the post-COVID-19 condition.

“The study found evidence of long COVID in children, with symptoms including cough, rales, fever, shortness of breath, runny nose, chills, nausea, fatigue, diarrhea and loss of appetite,” the authors concluded. “While diarrhea was rare, pulmonary rales, fever and chills were significantly associated with the post-COVID-19 condition, consistent with previous studies.”